EDUARDO FERREIRA BORBA NETO
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Clínica Médica, Faculdade de Medicina - Docente
LIM/17 - Laboratório de Investigação em Reumatologia, Hospital das Clínicas, Faculdade de Medicina
LIM/17 - Laboratório de Investigação em Reumatologia, Hospital das Clínicas, Faculdade de Medicina
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article 18 Citação(ões) na Scopus High prevalence of metabolic syndrome in antisynthetase syndrome(2018) ARAUJO, P. A. O.; SILVA, M. G.; BORBA, E. F.; SHINJO, S. K.Objective A high frequency of metabolic syndrome (MetS) has been recently described in different idiopathic inflammatory myopathies, but not in antisynthetase syndrome (ASS). Therefore, the aim of the present study was to determine the prevalence of MetS in ASS and also its possible association with cardiovascular the risk factors and ASS-related disease characteristics. Methods A cross-sectional single centre study of 42 consecutive ASS patients was conducted from 2012 to 2015 and compared to 84 healthy individuals matched for gender, age, ethnicity and body mass index-matched (control group). MetS was defined according to the 2009 Join Interim Statement. Clinical and laboratory data were assessed according to a standardised protocol. Results ASS patients had a median age of 41.1 years with a predominance of female gender and white race. ASS patients had a higher frequency of MetS (42.9% vs. 13.1%; p<0.001) as well as of insulin resistance than controls. Moreover, ASS patients had higher resistin, lower leptin and similar adiponectin levels in serum than controls. Further analysis of ASS patients with (n=18) and without (n=24) MetS revealed that older age at disease onset (48.7 vs. 35.4 years; p<0.001) was identified in those with the syndrome but were similar regarding disease duration, disease status, treatment, insulin resistance and serum adipocytokine levels. Conclusion The prevalence of MetS was high in ASS patients that also had serum resistin and low leptin levels. As also identified in other idiopathic inflammatory myopathies, MetS in ASS is more prevalent in older patients.- Peliosis hepatis and systemic lupus erythematosus: A rare condition identified by magnetic resonance imaging(2018) CORDEIRO, Rafael Alves; HOFF, Leonardo Santos; GARCIA, Marcos Vinicius Fernandes; LEAO FILHO, Hilton Muniz; BORBA, Eduardo FerreiraPeliosis hepatis is a rare benign disorder characterized by the presence of multiple cavities filled with blood with no preferential localization in the liver parenchyma. It may be related to several etiologic conditions, especially infections and toxicity of immunosuppressive drugs. To our knowledge, there are only three articles reporting the association between peliosis hepatis and systemic lupus erythematosus. In this report, we describe a case of this rare condition, highlighting the importance of magnetic resonance imaging. A short review of this subject is also presented.
conferenceObject PERIPHERAL NERVOUS SYSTEM DISEASE IN SYSTEMIC LUPUS ERYTHEMATOSUS: THE ROLE OF PREDISPOSING CONDITIONS(2018) FARGETTI, S.; BONFA, E.; SHINJO, S. K.; PASOTO, S. G.; SEGURO, L. P. C.; LOPES, M. R. U.; GONCALVES, C. R.; BORBA, E. F.conferenceObject SHORT AND LONG-TERM FOLLOW-UP OF PERIPHERAL NEUROPATHY DUE TO SYSTEMIC LUPUS ERYTHEMATOSUS: EVIDENCE OF A FAVORABLE OUTCOME(2018) FARGETTI, S.; BONFA, E.; SHINJO, S. K.; PASOTO, S. G.; SEGURO, L. P. C.; LOPES, M. R. U.; GONCALVES, C. R.; BORBA, E. F.conferenceObject Clinical Features, Damage Accrual and Survival in Patients with Familial Systemic Lupus Erythematosus (SLE): Data from a Multiethnic, Multinational Latin American Lupus Cohort(2018) QUINTANA, Rosana; PONS-ESTEL, Guillermo J.; ROBERTS, Karen; SACNUN, Monica; SERRANO, Rosa Maria; NIETO, Romina; CONTI, Silvana; GERVASONIL, Viviana; CATOGGIO, Luis J.; SORIANO, Enrique R.; SCOLNIK, Marina; GARCIA, Mercedes; ALVARELLOS, Alejandro; SAURIT, Veronica; BERBOTTO, Guillermo; SATO, Emilia; COSTALLAT, Lilian; BORBA, Eduardo; BONFAL, Eloisa; XAVIER, Ricardo M.; SILVA, Ana Carolina de Oliveira e; MOLINA, J. F.; IGLESIAS-GAMARRA, Antonio; GUIBERT-TOLEDANO, Marlene; REYES, Gil A.; MASSARDO, Loreto; NEIRA, Oscar J.; CARDIEL, Mario H.; BARILE, Leonor; AMIGO, Mary Carmen; SILVEIRA, Luis H.; TORRE, Ignacio Garcia de la; ACEVEDO-VASQUEZ, Eduardo; UGARTE-GIL, Manuel; ALFARO-LOZANO, Jose; SEGAMI, Ines; CHACON-DIAZ, Rosa; SPINETTI, Maria H. Esteva; GOMEZ-PUERTA, Jose A.; ALARCON, Graciela S.; PONS-ESTEL, Bernardo A.- Juvenile dermatomyositis: is periodonta disease associated with dyslipidemia?(2018) KOZU, Katia T.; SILVA, Clovis A.; AIKAWA, Nadia E.; PEREIRA, Rosa M. R.; SALLUM, Adriana M.; SAVIOLI, Cynthia; BORBA, Eduardo; CAMPOS, Lucia M.Background: Association between periodontal disease and dyslipidemia was recently reported in healthy adults. However, a systematic evaluation of concomitant periodontal diseases and lipid profile was not carried out in juvenile dermatomyositis (JDM). A cross-section study was performed in 25 JDM patients and 25 healthy controls, assessing demographic data, periodontal evaluation, fasting lipoproteins and anti-lipoprotein lipase antibodies. Disease parameters, laboratorial tests and treatment were also evaluated in JDM patients. Results: The mean current age was similar in patients and controls (11.5 +/- 3.75 vs. 112 +/- 2.58 years,p = 0.703). Regarding lipid profile, the median triglycerides [80(31-340) vs. 61(19-182)mg/dL,p= 0.011] and VLDLD 6(6-68) vs. 13(4-36)mg/dL,p= 0.020] were significantly higher in JDM patients versus controls. Gingival vasculopathy pattern was significantly higher in the former group (60% vs. 0%,p = 0.0001), as well as the median of gingival bleeding index (GBI) [24.1(4.2-69.4) vs. 11.1(0-66.6)%,p= 0.001] and probing pocket depth (PPD) [1.7(0.6-2.4) vs.1.4(0-2.12) mm,p = 0.006]. Comparison between JDM patients with and without dyslipidemia revealed that the median of dental plaque index (PI) [100(26.7-100) vs. 59(25-100)%,p = 0.022], PPD[1.9(0.6-2.4) vs. 1.4(1.2-1.8)mm,p= 0.024] and clinical attachment level (CAL) [1.31(0.7-1.7) vs. 0.8(0.6-1.7)mm,p = 0.005] were significantly higher in patients with dyslipidemia. Further analysis between JDM patients with and without gingivitis revealed that the median of current age [12.4 (8.3-18.4) vs. 9.2 (5.5-17.5) years, p = 0.034] and disease duration [7.09 +/- 3.07 vs. 3.95 +/- 2.1 years, p = 0.008] were significantly higher in the former group. Conclusion: Our study showed that gingival inflammation seems to be related to dyslipidemia in JDM patients, suggesting underlying mechanisms for both complications.
- Effectiveness of renoprotective approaches for persistent proteinuria in lupus nephritis: more than just immunosuppression(2018) CASTRO, M.; UGOLINI-LOPES, M.; BORBA, E. F.; BONFA, E.; SEGURO, L. P. C.Objective The objective of this study is to evaluate the efficacy of a tightly controlled renoprotective protocol in systemic lupus erythematosus (SLE) patients with persistent proteinuria. Methods Thirteen SLE patients with nephritis and persistent proteinuria (>1 g/24 hours) were included. The protocol consisted of regular clinical evaluations every two weeks to assess blood pressure (BP, target <130/80 mmHg), adherence to therapy, diet and smoking. No change in immunosuppressive drugs was allowed but reduction of glucocorticoid dose was permitted if indicated. Clinical, laboratory and treatment evaluations were performed at baseline and at the end of the study (after three months). Results SLE patients had a mean age of 37.85 +/- 7.68 years and disease duration of 9.85 +/- 7.29 years. At baseline, patients had a mean duration of maintenance therapy of 10.38 +/- 7.56 months, 12 with mycophenolate mofetil (92.3%) and one with azathioprine (7.7%). At least one dose optimization of antihypertensive regimen was required in all patients during the study. Seven patients (53.8%) had BP>130/80mmHg at baseline. At the end, 11 patients (84.6%) achieved stable BP target; 92.3% were using an angiotensin-converting enzyme inhibitor, 53.9% an angiotensin receptor blocker, and 46.2% were using combined therapy. All patients had a significant reduction in proteinuria levels (2.26 +/- 1.09 vs 0.88 +/- 0.54 g/24 hours, p < 0.001) and 61.5% achieved proteinuria <1 g/24 hours. A significant decrease in mean prednisone dose was observed (10.96 +/- 6.73 vs 5.38 +/- 3.36 mg/day, p = 0.013) as well as mean Systemic Lupus Erythematosus Disease Activity Index score (4.38 +/- 0.72 vs 3.08 +/- 1.86, p = 0.043). No significant changes were identified in serum creatinine, albumin, potassium, complement 3 and complement 4 levels (p > 0.05). Conclusion This study provides evidence that a tightly controlled renoprotective protocol is effective in reducing persistent proteinuria in lupus nephritis. The concomitant reduction of prednisone without any change in immunosuppression reinforces the importance of strategies beyond the treatment of nephritis activity.
conferenceObject Patients Characteristics and Patters of Treatment in Refractory Systemic Lupus Erythematosus Patients in the Pre-Biologic Period: Data from a Multiethnic, Multinational Latin American Lupus Cohort(2018) PONS-ESTEL, Guillermo J.; SCOLNIK, Marina; SORIANO, Enrique R.; HARVEY, Guillermina; QUINTANA, Rosana; GARCIA, Mercedes; SAURIT, Veronica; DRENKARD, Cristina; BERBOTTO, Guillermo; SATO, Emilia; COSTALLAT, Lilian; BONFA, Eloisa; BORBA, Eduardo Ferreira; BRENOL, Joao C. Tavares; SILVA, Nilzio A. da; CAVALCANTI, Andre; IGLESIAS-GAMARRA, Antonio; GUIBERT-TOLEDANO, Marlene; REYES, Gil A.; MASSARDO, Loreto; NEIRA, Oscar; CARDIEL, Mario H.; BARILE, Leonor; AMIGO, Mary Carmen; SILVEIRA, Luis H.; TORRE, Ignacio Garcia de la; SERRANO, Rosa Maria; ACEVEDO-VASQUEZ, Eduardo; UGARTE-GIL, Manuel; SEGAMI, Lees; GERVASONI, Viviana; CONTI, Silvana; CHACON-DIAZ, Rosa; ESTEVA-SPINETTI, Maria H.; PONS-ESTEL, Bernardo A.article Efecto de los antimaláricos sobre los diferentes dominios del índice de daño SLICC en pacientes de la cohorte GLADEL(2018) PONS-ESTEL, Guillermo J.; QUINTANA, Rosana; WOJDYLA, Daniel; ALARCÓN, Graciela S.; SERRANO, Rosa María; UGARTE-GIL, Manuel; PIMENTEL-QUIROZ, Víctor; SORIANO, Enrique R.; CATOGGIO, Luis J.; SCOLNIK, Marina; SACNUN, Mónica; SAURIT, Verónica; CAEIRO, Francisco; ALVARELLOS, Alejandro; SARANO, Judith; GARCÍA, Mercedes; ONETTI, Laura; DRENKARD, Cristina; BERBOTTO, Guillermo; SCHERBARTH, Hugo R.; SATO, Emilia; BONFA, Eloisa; FERREIRA BORBA, Eduardo; COSTALLAT, Lilian; XAVIER, Ricardo; TAVARES BRENOL, Joao C.; DA SILVA, Nilzio A.; CAVALCANTI, Fernando; MASSARDO, Loreto; JACOBELLI, Sergio; NEIRA, Oscar; MOLINA, José F; VÁSQUEZ, Gloria; GÓMEZ-PUERTA, José A.; ALONSO GONZALEZ, Luis; IGLESIAS GAMARRA, Antonio; GUIBERT-TOLEDANO, Marlene; REYES, Gil A.; CARDIEL, Mario H.; PASCUAL-RAMOS, Virginia; GARCÍA DE LA TORRE, Ignacio; BARILE, Leonor; SILVEIRA, Luis H.; AMIGO, Mary-Carmen; SAUZA DEL POZO, María Josefina; ACEVEDO-VÁSQUEZ, Eduardo M.; ALFARO-LOZANO, José; SEGAMI, María Inés; CHACÓN-DÍAZ, Rosa; ABADI, Isaac; ESTEVA SPINETTI, María H; PONS-ESTEL, Bernardo A.Objective: To assess the effects of antimalarials (AM) over the items of the SLICC Damage Index (SDI). Methods: Patients with recent (≤2 years) diagnosis of systemic lupus erythematosus (SLE) from the GLADEL cohort were studied. End-point: increase in items SDI since cohort entry. Independent variables (socio-demographic, clinical, laboratory and treatment) were included. The effect of AM as a time dependent variable on most frequent SDI items (adjusting for potential confounders) was examined with a multivariable Cox regression model. Results: Of the 1466 patients included in this analysis, 1049 (72%) received AM with a median exposure time of 30 months (Q1-Q3: 11-57). Damage occurred in 665 (45%) patients during a median follow-up time of 24 months (Q1-Q3: 8-55). There were 301 integument, 208 renal, 149 neuropsychiatric, 98 musculoskeletal, 88 cardiovascular and 230 others less frequently represented damages. After adjusting for potential confounders at any time during follow-up, a lower risk of renal damage (HR 0.652; 95% CI: 0.472-0.901) and borderline for neuropsychiatric damage (HR 0.701, 95% CI: 0.481-1.024) was found. Conclusion: In the GLADEL cohort, after adjustment for possible confounding factors, AM were independently associated with a reduced risk of renal damage accrual.- Exercise Increases Insulin Sensitivity and Skeletal Muscle AMPK Expression in Systemic Lupus Erythematosus: A Randomized Controlled Trial(2018) BENATTI, Fabiana B.; MIYAKE, Cintia N. H.; DANTAS, Wagner S.; ZAMBELLI, Vanessa O.; SHINJO, Samuel K.; PEREIRA, Rosa M. R.; SILVA, Maria Elizabeth R.; SA-PINTO, Ana Lucia; BORBA, Eduardo; BONFA, Eloisa; GUALANO, BrunoSystemic lupus erythematosus (SLE) patients may show increased insulin resistance (IR) when compared with their healthy peers. Exercise training has been shown to improve insulin sensitivity in other insulin-resistant populations, but it has never been tested in SLE. Therefore, the aim of the present study was to assess the efficacy of a moderate-intensity exercise training program on insulin sensitivity and potential underlying mechanisms in SLE patients with mild/inactive disease. A 12-week, randomized controlled trial was conducted. Nineteen SLE patients were randomly assigned into two groups: trained (SLE-TR, n = 9) and non-trained (SLE-NT, n = 10). Before and after 12 weeks of the exercise training program, patients underwent a meal test (MT), from which surrogates of insulin sensitivity and beta-cell function were determined. Muscle biopsies were performed after the MT for the assessment of total and membrane GLUT4 and proteins related to insulin signaling [ Akt and AMP-activated protein kinase (AMPK)]. SLE-TR showed, when compared with SLE-NT, significant decreases in fasting insulin [-39 vs. + 14%, p = 0.009, effect size (ES) = -1.0] and in the insulin response to MT (-23 vs. + 21%, p = 0.007, ES = -1.1), homeostasis model assessment IR (-30 vs. + 15%, p = 0.005, ES = -1.1), a tendency toward decreased proinsulin response to MT (-19 vs. + 6%, p = 0.07, ES = -0.9) and increased glucagon response to MT (+3 vs. -3%, p = 0.09, ES = 0.6), and significant increases in the Matsuda index (+66 vs. -31%, p = 0.004, ES = 0.9) and fasting glucagon (+4 vs. -8%, p = 0.03, ES = 0.7). No significant differences between SLT-TR and SLT-NT were observed in fasting glucose, glucose response to MT, and insulinogenic index (all p > 0.05). SLE-TR showed a significant increase in AMPK Thr 172 phosphorylation when compared to SLE-NT (+73 vs. -12%, p = 0.014, ES = 1.3), whereas no significant differences between groups were observed in Akt Ser 473 phosphorylation, total and membrane GLUT4 expression, and GLUT4 translocation (all p > 0.05). In conclusion, a 12-week moderate-intensity aerobic exercise training program improved insulin sensitivity in SLE patients with mild/inactive disease. This effect appears to be partially mediated by the increased insulin-stimulated skeletal muscle AMPK phosphorylation.